Affiliate Registration

Kidzori Affiliate Application Form

This form is intended to provide the necessary information to enable our management team to determine whether you meet the established criteria to become an affiliate. All information provided in this form will be treated in the strictest confidence. Your comfirmation and submission of this application form do not in any way constitute a commitment or promised contract on the part of Kidzori or the applicant.

Affiliate Registration

"*" indicates required fields

Name*

Email*

Username*

Password*

Enter Password Confirm Password

Address*

City*

State/Province*

Postal Code*

Country*

Phone*

Date of Birth

This field is hidden when viewing the form

Upload proof of payment below*

Max. file size: 500 MB.

Bank Details:
Please pay to the following account details:
Name: LITTLE CALIPHS INTERNATIONAL SDN BHD
Bank Name: MAYBANK
Account No: 562106641810

Thank you

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